DOD, Veterans Affairs will use SOA to increase EHR interoperability

By Peter Buxbaum
Monday, November 24, 2008

The Defense and Veterans Affairs departments will migrate their respective electronic health record systems to a service-oriented architecture to enhance the interoperability of outpatient clinical data.

Stephen Jones, principal deputy assistant secretary of Defense for health affairs, made the announcement at a Pentagon press conference this morning.

SOA means that the systems will rely on Web services that connect loosely coupled, reusable components.

A study by Booz Allen Hamilton recommended the use of SOA, and officials accepted that recommendation, Jones said.

The decision came on the heels of speculation that DOD might ditch its EHR — AHLTA — in favor of VA’s Veterans Health Information Systems and Technology Architecture or another alternative.

“The Booz Allen study looked at three different options: building on the current approach, replacing AHLTA with VistA and replacing both with another commercial off-the-shelf solution,” Jones said.

Booz Allen recommended the first option, which would allow DOD and VA to “move forward with information sharing in a compatible way,” Jones said. He added that he could not provide cost or schedule information because the implementation effort is just beginning.

Officials from both departments described the progress DOD and VA have made toward sharing clinical information. “We are making strides, and we are on target to meet requirements,” said Dr. Gerald Cross, VA’s principal deputy undersecretary for health. “We are now sharing almost all digital information that is viewable.”

Dr. Robert Kolodner, national coordinator for health information technology at the Health and Human Services Department, said VA and DOD “lead the way for the rest of the federal government.” In the private sector, he added, only 17 percent of U.S. physicians and fewer than 20 percent of hospitals have fully deployed EHRs.

But Arthur Wu, staff director for the House Veterans’ Affairs Committee’s Oversight and Investigations Subcommittee, said DOD and VA have not moved quickly enough.

“We’ve been after them for years,” he said. “It’s a question of pushing two cultures together.”